The Hanen Program® – The beauty of the ‘4 S’

ByLondon Speech and Feeding
| |
Image by freepik

One of my favourite pieces of advice I give to parents is the ‘4 S’, a strategy coined by the Hanen Program® which I teach, particularly the ‘More than Words’ programme which is designed for and aimed at parents of children with Social Communication Difficulties or Autism. It is honestly one of those golden nuggets that I use myself in my practice and I highly recommend it to all my parents. There is something about terms like the ‘4 S’ that is easy to recall and therefore use.

Introduction

The ‘4 S’ is a strategy that helps to clarify the words we use with our children so that they can notice us, hear us and understand what we are saying.

Research shows that we use on average 120-200 words per minute during everyday conversation. That’s a lot! And our children who are still learning to communicate are often bombarded with endless speech coming at them all day long. If we take into account that many of our students are Gestalt Language Processors, we can see that picking out relevant chunks of what we are saying is not at all easy, and this contributes to our children’s delays.

So let’s look at the ‘4 S’

1. The first one is SAY LESS

This means we should use shorter, simpler sentences with good grammar, for example, something like: ‘let’s get ready, time to put our shoes on’ instead of what we might be saying: ‘come on then darling, let’s put your shoes on we need to get going it’s dark outside’ or similar.

Good grammar helps to give clues about what words mean and how they are used in sentences. So, instead of ‘shoes on’ say ‘let’s put our shoes on’.

2. The second one is STRESS

I hear you think ‘I am stressed!‘. – NO! here it means ‘highlight’. We use our voice to highlight the important words in our sentence or phrase. For example, when you say ‘this banana is so yummy’ you can stress the word ‘yummy’ by saying it a bit louder and you can make a gesture, like rubbing your tummy as you say it.

3. The third one is GO SLOW

This means to speak a bit slower than you normally would and add pauses. By slowing down the pace of our speaking we give our child time to think and understand what we are saying. When we allow for pauses after we have spoken, we are inviting our child to say something in response.

4. The last one is SHOW

Always remember to show actions, gestures, objects, and point to pictures while speaking to help support your child’s understanding. We can show our child what words mean by pointing to things or holding up objects whilst describing or talking about them.

At this point I would also like to recommend the use of Core Boards, and particularly Electronic AAC devices, such as LAMP Words for Life or PODD. I have written about this in other blogs but can always be persuaded to say a bit more on the matter… 😊 It is such a big help to have an AAC talker available for both the child and the adult so we can find words and pictures to help support the words we are saying.

For example, today when reading a book like The Hungry Caterpillar (so good!) I used my LAMP AAC talker to make comments as we were looking at the pages together with my student. Example: ‘Look! He is eating more cake he is very hungry’ using my AAC talker I was able to supplement my speech and at the same time I was inviting my minimally speaking child to press a button or two and reply with ‘cake!’ which they would not have said with their mouth otherwise.

5. It does say ‘4 S’ but really it should be ‘5’ except the fifth is not an ‘S’

The fifth is REPEAT.

Repeat words and phrases often throughout the day. When learning a language we all need to hear words and phrases several times and in different situations before we can understand, remember, and then eventually use them. Our children are ‘new language learners’ and so we can apply the same principles that we would when learning a new foreign language ourselves.

Any questions or need help with supporting your little one’s language please contact me via my contact form, or you could also check out www.hanen.org for advice and lots of inspiration.

Sonja McGeachie

Early Intervention Speech and Language Therapist

Feeding and Dysphagia (Swallowing) Specialist The London Speech and Feeding Practice

The London Speech and Feeding Practice

Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.

1

Similar Posts

  • Cycles Approach speech therapy: Why syllables come first

    ByLondon Speech and Feeding

    and why it matters more than you might think!

    If your child’s speech is difficult to understand, it can feel tempting to focus straight away on individual sounds: those tricky /S/, /K/, or /SH/ sounds that just won’t come out clearly.

    But in therapy, we don’t always start there.

    When a child is very difficult to understand, and I have ruled out that the underlying cause is motor-based, I often opt for the Cycles Phonological Approach. This is helpful for those kids where we can feel like we don’t know where to start! The Cycles Approach helps to generate a broad overall increase in speech clarity by sequentially targeting a variety of speech patterns over the course of 8–10 weeks.

    So rather than working on one sound until it’s ‘fixed,’ we:

    • Work on patterns (not just individual sounds)
    • Target each pattern for a short period of time
    • Then cycle to the next one
    • And come back around again later

    This mirrors how speech development naturally happens: gradually, with increasing accuracy over time.

    Why don’t we start by fixing erroneous sounds straight away?

    To use a metaphor, if a child doesn’t have a strong syllable structure, working on individual sounds is like decorating a house that doesn’t have solid walls yet.

    Many children with speech sound difficulties:

    • Drop syllables (e.g. ‘banana’ → ‘nana’)
    • Simplify longer words
    • Struggle to maintain rhythm and stress patterns

    So, before we refine speech sounds, we need to build the framework of speech.

    Why syllables come first in every cycle

    In the Cycles Approach, we always begin with 2- and 3-syllable words, even if that’s not the main concern.

    Why?

    Because syllable awareness supports:

    • Speech clarity (intelligibility)
    • Word structure and sequencing
    • Prosody (rhythm and stress)
    • Motor planning for longer words

    Without this, even perfectly produced sounds can still be hard to understand in real speech.

    What do ‘2 and 3 beats’ mean?

    When we talk about ‘beats’ we mean syllables you can clap.

    Try it:

    • ‘Table’ → ta-ble (2 beats 👏👏)
    • ‘Banana’ → ba-na-na (3 beats 👏👏👏)

    In therapy, we help children:

    • Hear the beats
    • Feel the rhythm
    • Produce the full word (without dropping parts)

    What this looks like in therapy

    In my sessions, this part of the cycle is active, visual, and repetitive.

    You might see me using:

    • 👏 Clapping or tapping out syllables
    • 🧩 Using visual supports or blocks for each beat
    • 🎲 Play-based repetition of target words
    • 🎯 High-frequency practice (lots of turns!)

    I also keep the focus on success and flow, rather than correction.

    If you’re watching the video clip I’ve shared here, you’ll notice:

    • I’m not over-correcting every sound
    • I’m prioritising getting the whole word out
    • I’m building rhythm, confidence, and consistency

    Why this stage is so powerful

    It can look simple, but it’s doing a lot of heavy lifting.

    Working on syllables helps children:

    • Say longer words more clearly
    • Reduce ‘mumbling’ or collapsing of words
    • Improve overall intelligibility quickly
    • Prepare for more precise sound work later

    Often, parents notice early wins like:

    ✨ ‘They’re easier to understand already’

    ✨ ‘They’re saying longer words!’

    ✨ ‘They’re more confident speaking’

    And that’s before we’ve even fully targeted specific sounds.

    But will my child still learn their sounds?

    Yes. Absolutely.

    The Cycles Approach is structured so that after syllables, we move into:

    • Early developing sounds
    • Then more complex patterns (like fronting or clusters)

    And  importantly, we come back around again.

    Nothing is missed. It’s just sequenced in a way that supports success.

    A different way of thinking about progress

    One of the biggest mindset shifts with the Cycles Approach is this:

    👉 We’re not aiming for perfection straight away

    👉 We’re aiming for gradual system-wide change

    That means:

    • Your child doesn’t need to ‘master’ something before moving on
    • Progress builds across cycles
    • Speech becomes clearer over time, not overnight

    So, to sum up

    Starting with syllables might seem unexpected but it’s one of the most powerful foundations we can give a child whose speech is hard to understand.

    By building rhythm, structure, and confidence first, we make everything that comes next more effective.

    If your child is starting speech therapy and you notice we’re clapping words like ‘banana’ or ‘elephant’, there’s a very good reason for it.

    We’re not going backwards.

    We’re building from the ground up.

    We’re making later sound work more effective and more likely to generalise into everyday talking.

    Next steps:

    If you’re concerned about your child’s speech clarity or wondering whether they might benefit from a structured approach like this, feel free to get in touch. I offer individualised assessments and therapy plans tailored to each child’s speech profile whether that’s early sound development, phonology, or motor speech difficulties.

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.

    Health Professions Council registered
    Royal College of Speech & Language Therapists Member
    Member of ASLTIP

    Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.

    Parent FAQ section

    Why is my child practising words like ‘banana’ instead of sounds like /K/ or /S/?

    Because your child first needs to be able to hold and produce the full shape of a word. If they’re dropping syllables (e.g. ‘banana’ → ‘nana’), working on individual sounds won’t carry over into real speech. We build the structure first, then refine the sounds.

    What if my child can already say some long words?

    That’s great. But we’re looking for consistency and clarity across many words, not just a few familiar ones. This stage helps stabilise that skill so it becomes reliable in everyday talking.

    How long will we stay on syllables?

    Usually, this is a short but important phase within each cycle. We revisit it regularly, but we also move on to other patterns (like specific sounds or sound processes) within the same therapy block.

    Will this delay my child learning their sounds?

    No. In fact, it often speeds things up overall. Once the syllable structure is in place, children are much more able to use correct sounds in longer words and sentences.

    What can I do at home?

    Keep it simple and playful:

    • Clap out words together (e.g. ‘el-e-phant’)
    • Emphasise full words naturally in conversation
    • Repeat back what your child says with the full structure (without pressure)

    Consistency and exposure matter more than correction.

    My child gets frustrated. Will this help?

    Yes. Many children become frustrated when they’re not understood. Improving syllable structure often leads to quick wins in clarity, which can boost confidence and reduce that frustration.

    Building clearer speech: Why we practise syllables first

    What are syllables?

    Syllables are the ‘beats’ in words.

    • ‘Table’ = 2 beats (ta-ble)
    • ‘Banana’ = 3 beats (ba-na-na)

    Why is my child working on this?

    If your child:

    • Drops parts of words (‘banana’ → ‘nana’)
    • Mumbles longer words
    • Is hard to understand

    …then we need to build the structure of words first.

    This helps your child:

    ✔ Say longer words clearly

    ✔ Be easier to understand

    ✔ Feel more confident speaking

    What does this look like in therapy?

    We practise:

    • Clapping or tapping out beats 👏
    • Saying full words with rhythm
    • Repeating target words through play
    • Using visuals or actions to support learning

    How you can help at home

    Keep it light and playful, little and often!

    Try this:

    • Clap words together أثناء play (e.g. toys, food, animals)
    • Model full words naturally (‘Yes, ba-na-na!’)
    • Repeat and expand what your child says

    Example:

    Child: ‘nana’

    You: ‘Yes! Ba-na-na‘

    Important to know

    • This is a key first step in speech therapy
    • We will move on to sounds—but this helps them stick
    • Small changes here can make a big difference in clarity
    3

  • Can AI help my child’s speech delay? What it can do and what it can’t

    ByLondon Speech and Feeding

    If you’re worried about your child’s speech, you are absolutely not alone. Many parents I work with tell me the same thing:

    ‘I’ve been Googling…’
    ‘I asked ChatGPT what activities to try…’
    ‘TikTok said we should practise this sound every day…’

    It makes complete sense. When waiting lists are long, evenings are quiet, and your child is struggling to communicate, it’s natural to look for help wherever you can find it.

    AI tools can actually be helpful in some ways. But they also have clear limits especially for children with significant speech delays or speech sound disorders.

    Here’s an honest, balanced guide to what AI can do, and what it simply can’t.

    ✔️ What AI can help with

    1. Explaining things in simple language

    AI can be very helpful for explaining speech and language terms in a way that’s easy for parents to understand for example, what a phonological delay is, or what Childhood Apraxia of Speech means. It can also suggest possible reasons for a child’s speech delay based on the information you provide.

    The difficulty is that parents (or teachers) can only ask questions based on what they notice or perceive to be the problem. In practice, this doesn’t always tell the full story. For example, parents often report that their child ‘can say certain words’, but during an assessment we may find those words are actually produced with consistent error patterns. These patterns give important clues about the underlying nature of the difficulty, whether it’s a delay or a disorder and they guide the speech therapist in choosing the most effective targets to improve intelligibility.

    2. Suggesting games and activities

    AI is very good at suggesting ideas for games and practice, such as word lists, simple play activities, sound practice games, book suggestions, and ways to encourage talking within everyday routines. These can be especially helpful when you feel stuck or want some fresh inspiration for supporting your child at home. It can help to think of AI as a big ideas bank, somewhere to dip into when you need new, playful ways to keep practice engaging.

    3. Helping you prepare questions for a therapist

    Some parents use AI to list questions before an assessment, understand reports and organise concerns.

    This can make therapy feel less overwhelming and more collaborative.

    Used this way, AI can actually support the therapy process.

    ❌ Where and why AI cannot replace real life speech therapy

    There is substantial research supporting the effectiveness of real-life speech therapy compared to generic online resources or AI-generated suggestions. Here are some key points highlighting why in-person therapy is often more beneficial:

    • Personalisation: Speech therapists assess each child’s unique needs, strengths, and challenges through direct observation and interaction. This personalised approach allows for tailored interventions that address specific issues, which generic resources cannot provide.
    • Nuanced understanding: Therapists are trained to recognise subtle cues in speech production, including the nuances of sound articulation, language comprehension, and social communication. This expertise enables us to identify underlying issues that may not be apparent through generic assessments.
    • Motivational support: A speech therapist can provide encouragement, motivation, and emotional support, which can significantly enhance a child’s willingness to participate and engage in therapy. This relational aspect is crucial for building confidence and reducing anxiety around communication.
    • Evidence-based practices: As a highly trained and specialised speech therapist I utilise evidence-based practices that are grounded in research, ensuring that the techniques used are effective and up to date. This contrasts with generic online information, which may not always be reliable or validated.
    • Progress monitoring: In-person therapy allows for ongoing assessment and adjustments to the treatment plan. We track progress over time and modify strategies as needed, ensuring that the therapy remains effective and relevant.

    Research studies consistently show that individualised, face-to-face interventions lead to better outcomes in speech therapy than generalised approaches. For parents and caregivers, seeking professional help tends to provide a more effective path toward improving their child’s communication skills.

    The healthiest way to think about AI

    AI works best as a starting point, not a substitute. You might use it to understand your child’s report and learn how speech develops,

    But if your child has significant delay or difficulty being understood, what makes the real difference is:

    • A tailored assessment
    • A clear therapy plan
    • Expert target selection
    • Ongoing adjustment
    • Support for both child and you the parent!

    Dear parents,

    If you’ve been turning to AI for help, it doesn’t mean you’re doing anything wrong. It means you care!

    But please know the best outcomes usually come from combining your daily support at home with guidance and support from your speech therapist who knows you and your child.

    Many of my past and present clients tell me that they really value my ‘handholding’ and me guiding them in between the sessions. A quick check in is often all that is needed but it makes a huge difference!

    If you’d like support or advice, please contact me and I can help guide the next steps.

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.

    Health Professions Council registered
    Royal College of Speech & Language Therapists Member
    Member of ASLTIP

    Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.

    3
  • · ·

    Baby-led weaning: Empowering little eaters from the start

    ByLondon Speech and Feeding

    I had a mum ask me about Baby Led Weaning the other day. So I thought I would write a blog on all the useful questions she had and what we discussed as it may help lots of mums and dads out there.

    Image by Freepik

    As a Paediatric Feeding SLT, one of the exciting developments in recent years is the growing interest in baby-led weaning (BLW). This approach to introducing solids has gained significant traction, and for good reason. It empowers infants to take the lead in their feeding journey, fostering a positive relationship with food and supporting important developmental milestones.

    What exactly is baby-led weaning?

    At its core, baby-led weaning is about offering your baby appropriately sized and textured solid foods from the very beginning, allowing him or her to self-feed. Instead of spoon-feeding purées, you present whole, soft foods that your baby can grasp, bring to his or her mouth, and explore at his or her own pace. This means no mashing, no blending, and no forcing spoons into reluctant mouths. It’s a fun, messy, and intuitive process that is led by your baby’s natural instincts.

    The genesis of baby-led weaning

    ‘Baby-led weaning’ was popularised by British health visitor Gill Rapley. In the early 2000s, Rapley observed that babies naturally develop the skills needed to self-feed and that traditional spoon-feeding might actually hinder this development. Her work, particularly her book Baby-Led Weaning: The Essential Guide to Introducing Solid Foods (co-authored with Tracey Murkett), published in 2008, brought BLW into the mainstream and provided a structured framework for parents. Her research and observations highlighted the benefits of trusting a baby’s innate ability to regulate his or her intake and explore different textures.

    What’s the deal?

    Implementing BLW is simpler than you might think, though it does require a shift in mindset. Here’s a breakdown of what it typically involves:

    • Readiness is key: The golden rule of BLW is to wait until your baby shows clear signs of readiness. This isn’t about age alone, but rather developmental milestones. Your baby should be at least six months old, able to sit unassisted, have good head and neck control, show an interest in food (e.g., reaching for yours), and have lost his or her tongue-thrust reflex (which pushes solids out of his or her mouth).
    • Offer finger foods: Start with soft, easily graspable foods cut into finger-sized sticks or spears. Think cooked sweet potato fries, steamed broccoli florets (soft enough to mash with gentle pressure), banana sticks, or avocado slices. The goal is for babies to be able to pick it up and get some into their mouth.
    • Embrace the mess: BLW is inherently messy, especially in the beginning. Food will be squished, dropped, and smeared. This is a crucial part of the learning process as babies explore textures, smells, and the properties of food. A wipeable mat under the highchair and a good bib are your best friends!
    • Observe, don’t interfere: Allow your baby to lead. He or she will decide what to eat, how much, and how quickly. Avoid putting food into his or her mouth or pressuring him or her to eat more. This respects his or her hunger and fullness cues, laying the foundation for healthy eating habits.
    • Continue breastmilk or formula: Until your baby is well-established on solids, breastmilk or formula remains his or her primary source of nutrition. Solids are for exploration, taste, and developing skills, gradually increasing in quantity over time.

    The benefits of baby-led weaning

    The advantages of BLW extend far beyond simply getting food into your baby. From a speech and feeding perspective, the benefits are compelling:

    • Develops oral motor skills: Chewing, gnawing, and manipulating various food textures are crucial for developing the muscles in the mouth, jaw, and tongue. This strengthens the oral motor skills necessary for speech development.
    • Enhances fine motor skills and hand-eye coordination: The act of grasping food, bringing it to the mouth, and coordinating these movements significantly refines fine motor skills and hand-eye coordination.
    • Promotes self-regulation and intuitive eating: By allowing babies to control their intake, BLW helps them tune into their own hunger and fullness cues, fostering a healthy relationship with food and reducing the likelihood of overeating.
    • Encourages adventurous eating: Exposure to a wide variety of tastes and textures from the outset can lead to less picky eating later. Babies are more likely to accept new foods when they have been in control of their exploration.
    • Facilitates family mealtimes: BLW integrates babies into family mealtimes from an early age, promoting social interaction and making mealtime a shared, enjoyable experience.

    When is baby-led weaning appropriate, and when not?

    While BLW offers numerous benefits, it’s not a one-size-fits-all approach.

    When BLW is appropriate:

    • When your baby meets all the developmental readiness signs: This is paramount for safety and success.
    • When you are comfortable with the mess and the learning curve: It requires patience and a relaxed attitude.
    • When you are committed to offering a variety of safe, appropriate foods.
    • When you are willing to learn about and practise safe food preparation to minimise choking hazards.

    When BLW might not be appropriate (or requires extra caution and professional guidance):

    • If your baby has a history of prematurity or significant developmental delays: His or her oral motor skills might not be sufficiently developed.
    • If your baby has certain medical conditions or anatomical differences (e.g., cleft palate, severe reflux, swallowing difficulties): These may necessitate a modified approach to feeding.
    • If there are significant feeding difficulties, aversion, or a history of choking incidents.
    • If you feel overly anxious about choking: While BLW, when done correctly, is not associated with a higher choking risk than traditional weaning, parental anxiety can impact the feeding experience. Education and consultation with a professional can help alleviate these concerns.

    A note on safety: Choking hazards

    It’s crucial to understand the difference between gagging and choking. Gagging is a natural reflex that helps prevent choking and is very common in BLW as babies learn to manage food in their mouths. Choking is silent and serious. To minimise choking risks:

    • Always supervise your baby closely during mealtimes.
    • Offer appropriately sized and textured foods. Avoid small, round, hard foods like whole grapes, nuts, popcorn, and large chunks of meat.
    • Ensure your baby is sitting upright and calm.
    • Educate yourself on infant CPR.

    Final thoughts

    Baby-led weaning is a wonderfully empowering approach that celebrates a baby’s natural abilities and fosters a positive and independent relationship with food. As Speech and Language Therapists we often see the positive impact it has on oral motor development, self-regulation, and overall feeding confidence. By understanding what it entails, when it’s appropriate, and prioritising safety, you can embark on this exciting journey with your little one, helping him or her become a confident and capable eater from the very first bite.

    If you would like help and support with weaning your baby whilst continuing to breastfeed then please get in touch!

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.

    Health Professions Council registered
    Royal College of Speech & Language Therapists Member
    Member of ASLTIP

    Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.

    1
  • · ·

    Speech prompts and strategies I use in Speech Sound Therapy

    ByLondon Speech and Feeding

    This particular student has a mild motor planning difficulty and six weeks ago he came to me with a very strong lisp. In addition to the lisp he is struggling to produce a number of sounds, SH and L on its own and all the clusters (FL/BL/KL/PL) but also CH together with some vowel difficulties.

    The prompts are a mix partially from the DTTC (Dynamic Temporal and Tactile Cueing) model by Dr Edythe Strand as well as phonological models I have learned over the years, and some of them are my own.

    Visual/picture prompts and Images

    Here I use the ‘Flat Tyre’ Sound, to offer as an image for a new S sound and the ‘Tick Tock’ Sound for a new image of the T sound. Both cards are from the Bjorem Speech Sound Deck, which I love and use almost daily.

    Gestural Cues

    I like to use all the ‘cued articulation’ hand cues by Jane Passy for consonants and fricatives. Here we use our fingers and hand to illustrate what our tongue does, and we also show whether a sound is voiced or voiceless. When I use one finger it is voiceless (k/f/s/p) and when I use two fingers for the same cue it means that the voice needs to be turned on: (g/v/z/b/n/m). For vowels I like to use Pam Marshalla’s cue system.

    Simultaneous production

    We say the word together.

    Direct imitation

    I say the word and my student copies me directly.

    Imitation after a delay

    I say the word and then after a little wait my student says the word.

    Spontaneous production

    My student has now learned to say the word by him/herself.

    Offering feedback

    It sounds like… I just heard… I didn’t hear the first sound there? Can you try again?

    Letting the student reflect

    By just shaking my head or by looking quizzical so that my student realises something didn’t quite go right.

    Postitive reinforcement

    ‘Yes that was it, do it again, nice one…’

    Cognitive reframing

    This is a technique where we identify different semantic cues and metaphors or imagery cues, so instead of teaching or focusing on a sound we try out viewing each syllable from a different point of view.

    For example: ‘yellow’. I have had great success with this one: we start with just saying ‘yeah yeah yeah’. I might make a little joke and say something like ‘imagine your mum says tidy your bedroom, what do you say or what do you think?’ Answer: ‘yeah yeah yeah’. Then we practice ‘low’ together, I might blow some bubbles high and low and we talk about ‘low’. And then we put ‘Yeah’ and ‘Low’ together and now we have YELLOW!! It might at first still sound a bit odd, like ‘yea-low’ but we soon shape that up and have the real word.

    Each student is different and having a great rapport is crucial to our success.

    Then a little game break after some 7–10 or so repetitions and always trying to finish on a positive note.

    What game breaks do I use:

    Very quick ones! Students can post something, place a counter in a game, take out a Jenga block from the tower, pop in a counter for ‘connect 4’, stick a sword into the Pop the Pirate barrel or add a couple of Lego blocks to something they are building.

    I hope this is helpful, please contact me for any questions.

    Sonja McGeachie

    Early Intervention Speech and Language Therapist

    Feeding and Dysphagia (Swallowing) Specialist The London Speech and Feeding Practice

    The London Speech and Feeding Practice

    Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.

    1

  • A day in my life as an Independent Speech and Language Therapist

    ByLondon Speech and Feeding

    During the pandemic I wrote a blog on what my working day looked like. Now a good year has passed since coming back to some sort of normality and I thought I would update this ‘day in the life of an SLT’ as my working life has changed of course to reflect the ‘new normal’.

    I have become truly busy, perhaps busier than I have ever been to be honest. It’s probably mostly due to the fact that I do most of the aspects of my work myself — though I want to mention two invaluable people here without whom I could not function as well as I do: the excellent Nathalie Mahieu () helps me with my SEO, Insta posts and blog uploading and the wonderful Sue Bainbridge () makes sure that my accounts don’t get into trouble with His Majesty’s tax office.

    Attached to our role as Speech and Language Therapists is an arguably enormous amount of administration/paperwork and preparation required for each and every client. This needs to be factored in when deciding how many families I can realistically see each working day. For me it works out as typically 3–5 clients a day, Monday to Friday.

    So how does my day typically look? Each day varies a lot depending on what type of client I have, but on average it looks a bit like this:

    First thing in the morning — after having a coffee and a quick check-in with my besties on WhatsApp — I do my Buddhist chanting for about an hour. My Buddhist prayers are the base of all I do and get me connected to my higher purpose and how to create value with each activity and each person I see that day. It sets me up for the day, I keep in mind who is going to come and see me and how I can best help them.

    Next up, I do the daily ‘spring-clean’ of my therapy room (on all fours! no joke ???? those kids see every speck!), vacuum the floors, wipe down the toys with flash-wipes and tidy up all my boxes, making sure that the battery toys are working, and everything else is in place. On to the guest toilet, the hallway needs to be rid of all the men’s shoes and trainers and coats… It’s endless what needs tidying when you are living with three men… This takes about 45 minutes.

    An articulation activity – packaging practice into a little game

    Then I prep for all my clients that day. I have now got so much quicker about selecting therapy materials. For one thing I have purchased so many toys and materials over the past five years that I can literally now open a shop and need to consider building an extension! ???? The upside is that it is now very easy for me to select a good handful of toys or games for any one child, even at a minute’s notice. Though, on average, I spend about 30 minutes per child preparing activities.

    Hurrah, it’s 11 am and my first client of the day arrives and the fun begins.

    When they leave around an hour later, the cleaning and wiping down starts again, this time less extensively. I write up my notes and send homework whilst enjoying a cuppa.

    The next client comes at 12.30 pm and once they have left, floor cleaned, toys wiped, notes written it is time for a quick lunch. No more than half an hour usually.

    Afternoon clients tend to be one more little one (nursery age) at 2.15 pm and thereafter I see mostly older school children for a variety of reasons (mainly speech production but also some language-based activities). I tend to say farewell to my last client of the day around 6 pm. I spend another hour, sometimes more, on writing up notes, answering new enquiries, blogging and phone calls to keep my service fresh, inspirational and exciting.

    And then dinner and the rest of the day rushes by. I tend to finish my day with some more Buddhist chanting, not a lot, perhaps 10–20 minutes to reflect on what has gone well and what could have been better — re-determine to improve or make better as needed.

    Tele therapy activity using online materials plus a coreboard

    In terms of where I provide a service, I still do a good mix of online clients (tele-therapy) and in-person clients in my clinic, which I love. Occasionally, I visit children in their nursery or at home but this service is now only available for long-standing clients.

    Each client is hand-picked to make sure that we are a good fit: no one client gets the same treatment as another; each client is unique, we get to know one another well over the time we work together and they are always highly valued. That takes time and, in reality, each client gets about two hours of my time. That is the actual session plus all the preparation and aftercare, i.e., bespoke hand holding, tweaks, problem solving and reassurance in between sessions.

    I absolutely love this way of working and would not ever want to do anything else. Nearly three decades of working both in the NHS and in private practice, countless courses (continual professional development) have enabled me to flourish as a therapist and I know that I offer something special and very valuable to my clients.

    My unique way of working affords all my lovely clients the help they need to support their children to make progress; and it gives me the right balance of job satisfaction and work life balance for now. My lovely reviews and testimonials tell me that my clients appreciate my service and this at the end of the day is the most important.

    If you are interested in exploring Buddhism/buddhist chanting then check out this link (https://sgi-uk.org/), and feel free to contact me about that specifically, regardless of whether you want speech therapy. I am always happy to chat about Buddhism, it has been so enriching for the last 43 years of my life.

    If you need help with your child, please do not hesitate to contact me.

    Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.

    1

  • Explore 12 questions to determine whether your child may be Autistic

    ByLondon Speech and Feeding
    A young boy is in the foreground and has turned his head away from the woman sitting next to him.
    May your child be autistic?

    As professionals, when diagnosing young children with an Autistic Spectrum Condition, it is vital we work as a multi-disciplinary team, so you will likely see many professionals. This may include Educational Psychologist, Dietician, General Practitioner, Occupational Therapist, Paediatrician, Special Educational Needs Coordinator, Speech and Language Therapist and Social worker. Once the evidence is collated, then a diagnosis may be made.

    You may be wondering what are some of the early signs of social communication difficulties? Whilst no autistic child is the same and we know Autism is very much a very wide spectrum of abilities and needs there are some autistic spectrum characteristics we do typically see in the early years of childhood. You may wish to think about these areas or presentations to help you prepare for the Speech and Language Therapy appointment.

    Twelve questions

    1. Does your child respond to their name?
    2. Are they fixated with watching their hands?
    3. Do they have sensory processing difficulties such as bright lights, food textures, or loud noises?
    4. Are they meeting their milestones or are they delayed?
    5. Do they flap their arms or legs when excited?
    6. Have you noticed any rocking back and forth?
    7. Do they blink excessively or display any facial tics?
    8. Do they play with a particular sort of toy e.g. spinning toys?
    9. Have you noticed that they lack interest in toys?
    10. Have they regressed in their language? Perhaps you’ve noticed they are not using words that they have previously learnt.
    11. Do they use gestures to communicate their needs? How do they communicate their wants and needs?
    12. Do they appear to be in their own world?

    You are not alone

    These questions are by no means exhaustive and there are many more factors to consider. But it is important to trust your instincts as you are the expert on your child and know your child the best. Regardless of whether you see all of the above points or none, do not hesitate to have an assessment if you are concerned as, even if it turns out to be nothing to worry about, there is always at least one or two great pieces of advice I can offer you on the way and you will leave feeling hopeful and empowered. It’s always best to seek early intervention with communication difficulties. This allows strategies and support to be put in place. Never feel alone, always speak out.

    Find communication support here from me, Sonja, (Specialist Speech and Language Therapist)

    Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.